(05-07-2021, 10:14 AM)godletmesleep Wrote: The 6 Flows do not look like class 1's from what I can see, not to mention the machine started flagging those types of clusters. The Wiki provides some examples of class 1s and there is no plateau beforehand on such flows. Nor does that explain why they look different from prior breathes taken in the same night that are easily distinguished as class one.

I am starting at the zero line when evaluating those flows, not necessarily the the middle of the exhale. Doesn't seem to make much sense for someone to inhale slightly, exhale slowly, and then make a larger inhale? Or exhale and withhold their breath for a few moments before starting to inhale. That's what those 2's are appearing to be.

Then again, maybe I'm wrong, I'm just going off what literature I could find (which isn't much)

(05-07-2021, 01:47 PM)sheepless Wrote: your 'trainwreck' is more than acceptable to your providers with ahi <5. of course lower is better. I do see some tendency toward clustering, the most obvious just after 2:30. you mentioned back sleeping as something to work on & that, fewer/lower pillow(s) & adjusting the cervical collar may reduce your oa.

your leaks aren't terrible but are a little high. leaks frequently disturb me & maybe you so working on that may help too.

at some point (they tell us when ahi <5 but we like to be closer to 2) we have to start looking beyond apnea & pap to identify problems & solutions. e.g., other health issues, sleep hygiene, food, drink, stress, meds, environmental disturbances like temp, humidity, noise, light, pets, etc.

you mentioned something about a full blown bilevel vs the resmed. not sure what you mean by that. it's probably a longshot but you might be able to trade in your pr for the resmed apap with epr that might make you feel  better about your flow limitations which from what I've seen aren't that bad. if you're able to get a resmed vauto, that would be the better (bilevel) solution to oa, obstructive h & flow limitations.

(05-07-2021, 01:47 PM)sheepless Wrote: your leaks aren't terrible but are a little high. leaks frequently disturb me & maybe you so working on that may help too.

(05-07-2021, 07:25 PM)godletmesleep Wrote: I can't get OSCAR to realize that going over 13L/min is NOT an excessive leak for my mask. But regardless of whatever setting I put in preferences it will not adjust properly. So I've realized the Leak Rate line is completely useless sometimes. Sometimes I just have to go back into Sleepyhead, because it will actually calculate it properly.

(05-07-2021, 08:42 PM)kappa Wrote:

(05-07-2021, 07:25 PM)godletmesleep Wrote: I can't get OSCAR to realize that going over 13L/min is NOT an excessive leak for my mask. But regardless of whatever setting I put in preferences it will not adjust properly. So I've realized the Leak Rate line is completely useless sometimes. Sometimes I just have to go back into Sleepyhead, because it will actually calculate it properly.

The Leak Rate limit ("Flags leaks over threshold") in OSCAR is only applied on CPAP data import - if you change it later it will only apply to subsequent imports. You can purge data for a given day (or all days for that machine) and then reimport. The machine flagged "Large Leak" appears to trigger at a leak rate of around 40, so you could set the threshold there (don't worry about the "Total Leaks" number - this includes expected leak rate from your mask vents).
I also have PLM, and when experimenting with a PR machine I found that it would often misclassify CAs as OAs and ramp up pressure. I find higher pressures (and any pressure variation like flex/epr) very disturbing to sleep so ended using a fixed lower pressure. I then had a CPAP titration sleep study which found that I should use an even lower pressure as they noted disturbance even at the 7cm I had self titrated too and recommended 6cm (which is enough to treat my mild OSA). I'm also been on a journey to find appropriate an drug regime and diet to reduce my PLM.

(05-07-2021, 08:45 PM)godletmesleep Wrote: OSCAR will import it correctly, but if you make any preference changes even if unrelated to the leak threshold, it will immediately bounce back to 13 L/min flags.
My titration study put me at 7cm, and from what I was told is I had zero issues that night. Can't confirm because they never gave me the study. I felt better after that night but I don't know why.

(05-07-2021, 07:25 PM)godletmesleep Wrote: Leaks are an issue I've been neglecting, if not the cause of half of the issues. "aren't terrible" is a bit of an understatement, considering there are some hours where the leaks are over 60L/min...